【摘要】 目的探讨妊娠合并血液病导致血小板减少产妇行剖宫产术不同麻醉方式的应用。方法回顾过去12年血液病导致血小板减少产妇行剖宫产术297例,根据不同麻醉方式分为全身麻醉(generalanesthesia,GA)组和局部麻醉(local anesthesia,LA)组,获取产妇一般资料、术前日血常规及凝血功能检查结果、围产期产科及新生儿资料,并电话随访妊娠史和母婴现存身体状况。结果 GA组术前血小板计数显著低于LA组(P <0.05)。LA组具有更高新生儿5 min Apgar评分和术后镇痛使用率(P <0.05)。母婴现存结局两组间差异无统计学意义(P> 0.05)。结论血液病导致血小板减少产妇行剖宫产术,一般情况较差(血小板计数低下、多项血液指标异常、ASAⅣ-Ⅴ级等)首先考虑全身麻醉,如无禁忌则椎管内麻醉为最优选择。不同麻醉方式不会对术后母婴结局产生明显影响。更多还原

【Abstract】 Objective To explore the different applications of anesthesia for hematologic diseases-induced thrombocytopenia in cesarean section.Methods A total of 297 cases with hematologic diseases-induced thrombocytopenia who underwent cesarean section in the past 12 years were analyzed retrospectively.Patients were divided into general anesthesia(GA)and local anesthesia(LA)groups.General data of patients,blood routine indexes and coagulation function indexes before surgery and obstetric data were acquired.The pregnancy history and present outcome of puerperas and children were collected by phone call.Results The account of planet before surgery of group GA were significantly lower than that of group LA(P<0.05).The Apgar scores at 5 min after delivery and the rate of postoperative analgesia were higher in group LA(P<0.05).There were no significant differences in the present outcome of puerperal physical conditions and fetal growth(P>0.05).Conclusion sFor puerperas with serious hematologic conditions(thrombocytopenia,a series of abnormal blood indexes,ASA physical status Ⅳ or Ⅴ and so on),general anesthesia was recommended.Intravertebral anesthesia could be the best choice if there were no contraindications in patients.There was no significant difference in the prognosis of mothers and children between general anesthesia and local anesthesia.更多还原